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CMS finalizes small rate increases for dialysis providers

By Paul Demko  |  October 31, 2014

Medicare payments for end-stage renal disease will increase by 0.3% in 2015 under a final rule issued by the CMS Friday. The agency expects to pay $9 billion next year to more than 6,000 facilities for coverage of dialysis services to individuals with ESRD.

Miami PA gets 15 years in Medicare fraud case

By Lisa Schencker  |  October 23, 2014

A Miami physician assistant was sentenced this week to 15 years in prison for his role in a $200 million Medicare fraud case, even though his attorney argued he was not a central figure in the scheme.

Texas hospital executives convicted in Medicare fraud case

By Lisa Schencker  |  October 21, 2014

A federal jury in Texas convicted the former head of Houston's Riverside General Hospital, along with several others Monday, of attempting to defraud Medicare of $158 million for mental health services that were medically unnecessary or never actually provided.

Medicare.gov contractor looks to go public

Medicare.gov contractor looks to go public

By Bob Herman  |  October 21, 2014

Connecture, a technology company that powers and designs Web-based health insurance marketplaces, plans to go public. The Brookfield, Wis.-based company on Monday filed with the Securities and Exchange Commission for a proposed initial public offering of stock.

Medicare considers national coverage for new prostate cancer test

By Bob Herman  |  October 18, 2014

Medicare will begin initial coverage for a genetic prostate cancer test and will consider national coverage. A Medicare administrative contractor, Palmetto GBA, said it will pay for a diagnostic test that evaluates prostate cancer risk in men, and the nation's largest payer will reach out to...

New fed loans to promote rural ACOs

By Melanie Evans  |  October 18, 2014

The Obama administration plans to offer infrastructure loans to small and rural healthcare providers to participate in Medicare's program for accountable care organizations.

CMS monitors Baylor's efforts to curb rate of 'eloped' psych patients

CMS monitors Baylor's efforts to curb rate of 'eloped' psych patients

By Sabriya Rice  |  October 18, 2014

Baylor University Medical Center in Dallas has until the end of October to demonstrate to the CMS that it has addressed lapses that have allowed significant numbers of untreated psychiatric patients to walk out of its emergency department without staff realizing they had left.

Earnings report may reveal UnitedHealth's exchange plans

By Paul Demko  |  October 11, 2014

When UnitedHealth Group kicks off the third-quarter earnings season for insurers Thursday, reform watchers will be eager to hear more from its executives about their intentions for the 2015 Obamacare open enrollment.

Dialysis providers expect ACOs, payment cuts, consolidation

Dialysis providers expect ACOs, payment cuts, consolidation

By Beth Kutscher  |  October 11, 2014

The $25 billion dialysis industry faces transformation as it moves from offering a profitable niche service to what insurers see as a cost center under the population health-management approach.

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